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Individual

MR. KRIS-ANGELO NATIVIDAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
130 E 77TH ST, BLACK HALL 4TH FLOOR, NEW YORK, NY 10075-1851
(212) 434-3000
Mailing address
56 28TH AVE, BROOKLYN, NY 11214-5518
(917) 361-0986

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
363LA2200X
Adult Health Nurse Practitioner
Primary
306156
NY
363LG0600X
Gerontology Nurse Practitioner
340868
NY

Other

Enumeration date
01/22/2013
Last updated
01/22/2013
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